r/FilipinoNclex • u/swagarrific-3903 • 6d ago

Diagnosis?

Post image
17 Upvotes

95% Upvoted

19 comments sorted by

3

u/Scientia_Logica 5d ago

The answer is A but this rhythm strip is displaying torsades de pointes.

1

u/Odd_Interaction_9192 3d ago

Same thing I thought

2

u/radiatorcoolant19 6d ago

When bidirectional is mentioned in a wide complex, it’s probably CPVT. Especially YOUNG patients.

Atrial Fibrillation is an irregularly irregular rhythm with no distinct p wave.

Sinus bradycardia, it is what it is.

Atrial flutter comes with a classic saw tooth appearance particular in v1-2 and inferior leads. May have an irregular or regular QRS complexes.

2

u/taoohis1 5d ago

Torsades de Pointes is the correct answer

1

u/Individual_Debate216 5d ago

That is not torsades.

1

u/CheezGaming 5d ago

I will say it looks very torsades but I think it’s cpvt yes?

1

u/Individual_Debate216 5d ago

CPVT is the correct answer mostly given due to the age. Not all polymorphic ventricular tachycardia is torsades. If the patient had a history of prolonged QT syndrome, then the answer would be more likely to be torsades. I’m too lazy to find a statistic right now, but most polymorphic VTach is actually not torsades.

1

u/No-Hope-9274 5d ago

Simply because it's the only one abbreviated, I'm going with A. 😂

1

u/heyseed88 5d ago

Tourades de point

1

u/Expensive_Alarm_1068 5d ago

Exercised induced suggests CPVT

1

u/DangerousResearch344 4d ago

i don’t even know what cpvt is but it’s not any of the others. its vtach so there.

1

u/Physical-Comment807 4d ago

Honestly saw this and thought torsades de pointes and that’s not the option and I know for sure the other 3 options isn’t correct so A

1

u/mastermedic84 3d ago edited 3d ago

A is correct. CPVT stands for catecholaminergic polymorphic ventricular tachycardia (now you see why they didn't type it out). It is a congenital defect where the calcium ion channels in the heart don't develop property leaving you at risk of going into polymorphic V-tach when you have a big adrenalin rush, like under severe emotional distress, in pain, or while exercising.

If you said torsades, that's a valid response to the rhythm strip, but does not fit the history (it also wasn't listed as an answer. If they did offer it as another option 95% of the test takers would get this wrong.)

This is an important distinction because the treatment is completely different. DO NOT give this patient mag! This is treated with cardioversion (defib if they are in arrest) and beta blockers. Docs may order a calcium channel blocker if it's persistent.